Respir Case Rep. 2020; 9(1): 12-15 | DOI: 10.5505/respircase.2020.48802

A Case of Asymptomatic Pulmonary Limited Granulomatosis with Polyangiitis

Dilaver Taþ, Saime Ramadan
Baskent University, Istanbul Health Application and Research Hospital

A 50-year-old female patient was admitted to the Obstetrics and Gynecology Department with vaginal bleeding. The patient was diagnosed with uterine myoma, and an operation was scheduled. A chest radiography revealed suspicious bilateral nodules during the preoperative evaluation of the patient. A thoracic computed tomography revealed bilateral nodular lesions in the superior segment of the right lower lobe and the posterobasal segment of the left lower lobe. A core needle biopsy of the right lung revealed a granuloma formation, neutrophil and lymphocyte infiltration, and fibrinoid necrosis in the interstitial and perivascular area. c-ANCA positivity was detected in autoantibody tests. Eyes, ears, nose, mouth and nephrological examinations of the patient revealed no pathology. The patient was diagnosed with Pulmonary Limited Granulomatosis with Polyangiitis, based on the present findings. Treatment with low dose weekly oral methotrexate, prednisone and folic acid was planned. The patient underwent a total abdominal hysterectomy and a bilateral salpingo oophorectomy without complications. The case is presented with a literature review given the asymptomatic status of the patient and the rarity of the disease.

Keywords: granulomatosis with polyangiitis, pulmonary, asymptomatic

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Asemptomatik Akciðere Sýnýrlý Granülomatöz Polianjitis Olgusu

Dilaver Taþ, Saime Ramadan
Baþkent Üniversitesi, Ýstanbul Uygulama ve Araþtýrma Hastanesi

Elli yaþýnda kadýn hasta vajinal kanama nedeniyle Kadýn Hastalýklarý ve Doðum servisine baþvurmuþ. Hastaya miyoma uteri tanýsý konarak operasyon kararý verilmiþ. Hastanýn preoperatif deðerlendirme sýrasýnda akciðer grafisinde bilateral þüpheli nodül saptanmasý üzerine çekilen Toraks Bilgisayarlý Tomografisin’ de sað alt lob süperior segment ve sol alt lob posterobazal segmentte nodüler lezyonlar saptandý. Sað akciðer tru-cut biyopside ‘interstisyel ve perivasküler alanlarda granülom formasyonu, nötrofil ve lenfosit infiltrasyonu, fibrinoid nekroz’ izlendi. Otoantikor tetkiklerinde c-ANCA pozitifliði saptandý. Hastanýn Göz, K.B.B. ve nefrolojik muayenesinde patoloji saptanmadý. Mevcut bulgularla hastaya 'Akciðere Sýnýrlý Granülomatöz Polianjitis' tanýsý kondu. Düþük doz haftalýk oral metotreksat, prednizon ve folik asit tedavisi baþlandý. Hasta komplikasyonsuz total abdominal histerektomi ve bilateral salpingo ooferektomi operasyonu oldu. Hastanýn asemptomatik olmasý ve hastalýðýn nadir görülmesi nedeniyle, literatür tartýþmasý eþliðinde sunuldu.

Anahtar Kelimeler: granülomatöz polianjitis, akciðer, asemptomatik

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